Pharmacy Leaders Research Articles

CTN-0138: adaptation, implementation, and cluster randomized trial of a Community Pharmacy-Based Prescription Drug Monitoring Program Opioid Risk Assessment Tool—a protocol paper

Abstract Background As the opioid epidemic continues to have a major negative impact across the US, community pharmacies have come under scrutiny from legal systems attempting to hold them accountable for their role in over dispensing and lack of patient intervention. While the most available tool for monitoring patients’ opioid use is Prescription Drug Monitoring Programs (PDMP), these do not provide pharmacists with actionable information and decision support. Our study addresses this gap through three objectives: [1] incorporate validated opioid risk metric thresholds into a PDMP platform to create the Opioid Risk Reduction Clinical Decision Support (ORRCDS) tool; [2] assess ORRCDS’ ability to reduce patient opioid risk; [3] assess ORRCDS’ sustainability and viability for broader dissemination in community pharmacy. Methods For objective 1, our team is partnering with leadership from the largest US PDMP organization and a top-five pharmacy chain to implement ORRCDS into the pharmacy chain’s workflow following the Guideline Implementation with Decision Support (GUIDES) framework. For objective 2, our team will conduct a type-1 implementation mixed methods study using a 2-arm parallel group clustered randomized design. We anticipate enrolling ~ 6,600 patients with moderate and high opioid use risk during the 6-month enrollment phase across 80 pharmacies. This sample size will provide 96.3% power to detect a 5% or greater difference in responder rate between the intervention and control arm. Responders are patients with moderate-risk at baseline who reduce to low-risk or those with high-risk at baseline who reduce to moderate or low-risk at 180 days post last intervention. To accomplish objective 3, we will use the Consolidated Framework for Implementation Research (CFIR) to develop and execute cross-sectional qualitative interviews with pharmacists (n = 15), pharmacy leaders (n = 15), and PDMP leaders (n = 15) regarding long term adoption and sustainability of the ORRCDS tool. Conclusions A PDMP tool that addresses moderate- and high-risk opioid use is not available in community pharmacy. This study will implement ORRCDS in a large retail pharmacy chain that will include additional screening and guidance to pharmacy staff to address risky opioid medication use. Our results will make critical advancements for protecting patient health and addressing the opioid epidemic.

Impact of a social media post on improving an existing residency program.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. A social media post prompted reflection and changes to a longstanding pharmacy residency program. Pharmacy leadership utilized consultants with expertise in pharmacy residency training to help facilitate change and introduce new ideas to tenured staff. Other health systems working to continuously improve their residency programs may benefit from our example. The guiding principles of the changes were to align with the new harmonized residency program standards and reduce preceptor burden and potential burnout. Changes were made to the entire program's design, including new leadership, changes to committee structure, reduced requirements for preceptors that were not required in the standards, and resident recruitment and onboarding. We encourage residency programs to regularly evaluate program structure, design, and conduct to ensure alignment with the organization's evolving priorities as well as its mission and vision.

Survey to identify barriers and enablers to implementation of genomics in pharmacy practice across healthcare sectors in a rural community

Abstract Introduction The potential for genomics to improve patient outcomes is being harnessed via national strategy to embed genomic testing into NHS practice, and drive use of precision medicines and pharmacogenomics1. The national pharmacy genomics education and training strategic framework aims to empower the pharmacy workforce, across all sectors, to use genomics to support medicines optimisation2. Cornwall, a rural and coastal county, has areas of marked deprivation with poorer health outcomes3 and challenges in recruiting and retaining healthcare professionals. It is key that rural/coastal communities have equitable access to genomic services and expertise to avoid exacerbating pre-existing health inequalities. Aim To identify barriers and enablers to the implementation of genomics into pharmacy practice in a rural community. Methods Pharmacists and pharmacy technicians working in Cornwall were eligible to participate. An anonymised survey was compiled via Microsoft Forms of closed, multiple choice and optional open questions. Following piloting, the survey link was disseminated via email by pharmacy leaders in community pharmacy, primary and secondary care in May 2024. Responses were stored securely via NHS password protected IT systems and analysed via quantitative and thematic analysis. As this project is defined as a service evaluation, according to the UK NHS Health Research Authority, ethical approval was not required. Results Fourteen pharmacists and 7 pharmacy technicians participated, from primary and secondary care and community hospitals, with no participants from community pharmacy. Seven had received prior training in genomics (teaching sessions (n=5), webinars (n=1), podcasts (n=1), articles in journals (n=2)). One participant had received formal undergraduate training. Key barriers to the implementation of genomics included a lack of education and training (n=5), perceived cost of genomic testing (n=2), difficulty in accessing genomic services (n=1) and lack of expert panels (n=1). It was also felt that genomics services were limited to secondary/tertiary care (n=2). Respondents stated that the rural location impacted the availability of face-to-face training and resources to support training (n=17). Key enablers were the opportunity for precision prescribing (n=8), and improved patient outcomes (n=7). Genomics education and training (n=5) and resources to support training (n=11) were viewed as being pivotal to supporting the mainstreaming of genomics. Discussion and conclusion Participants were keen to further their genomics knowledge, with a preference for face-to-face training. Respondents also highlighted the need for allocated resources to support training. As emphasised in the strategic framework2, workforce upskilling is vital to the successful mainstreaming of genomics, particularly when the majority of pharmacy staff had not received any formal training. There were no participants from community pharmacy, indicating a requirement to further explore barriers and enablers in this cohort. Community pharmacy staff may be reluctant to participate if they perceive genomics to relate solely to secondary/tertiary care. Survey methodology also limited the detail that could be obtained from respondents. This provides helpful preliminary insights on barriers and enablers to genomics implementation into pharmacy practice in rural/coastal areas. Themes could be further explored via semi-structured interviews, with the aim of shaping interventions necessary to ensure equitable provision of genomics services and expertise to these communities.

Evaluation of the ENIGMA mentoring pilot; an approach to tackle leadership inequalities for ethnically diverse female pharmacists in general practice

Abstract Introduction Diversity in leadership positively impacts teams and productivity yet remains limited in pharmacy leadership. The NHS Pharmacy Workforce Race Equality Standard (PWRES) report1 highlights significant underrepresentation of ethnically diverse pharmacists in senior NHS Trust roles (Agenda for Change band 8a and above) compared to their representation in the general pharmacist workforce. This disparity is particularly pronounced for female pharmacists from ethnically diverse backgrounds, who make up 31.9% of all pharmacists but only 24.2% of those in band 8a and above, with a steep decline from 27.6% at band 8a to just 5.9% at band 91,2. To begin addressing this, we piloted the ENhancing leadershIp amonGst ethnically diverse feMale phArmacists (ENIGMA) mentoring scheme in general practice within Leeds. Aim The aim was to determine whether ENIGMA mentoring relationships supported leadership skill development, fostered networking, and developed authentic allies. We assessed the success of the pilot by exploring the perspectives of mentors and mentees and identifying their satisfaction with the scheme. Methods We recruited 18 experienced female senior leaders as mentors for ENIGMA. Mentee recruitment was conducted through dissemination of a flyer via social media, Microsoft Teams, email, and citywide meetings, offering places to the first 18 pharmacists who expressed interest, with no selection process. Mentors and mentees were paired based on mentee goals and mentor expertise. Mentees met their mentor 3 times in a 6-month period. Evaluation was undertaken through Microsoft Forms questionnaires completed anonymously by both mentors and mentees exploring how they experienced ENIGMA, benefits of the scheme, if they felt the scheme had enabled leadership skill development and how it had (or anticipated it would) impact(ed) on career development for the mentee. Ethical approval was deemed unnecessary as this was a service evaluation. Neither author-affiliated organisation is associated with the project. Results Of 18 mentoring pairs, 13 successfully completed the 6-month program. For five pairs, mentees did not establish contact. 62% of mentors responded to the questionnaire. 88% felt a positive impact on their mentoring skills and described a noticeable increase in mentee confidence and career focus. 100% of mentors would recommend the scheme. For mentees, 62% responded. 88% were ‘most satisfied’ with the experience and 88% felt their leadership skills improved because of participating. 75% met specific goals and 88% commented particularly on positive impact of the scheme. 100% of mentees would recommend ENIGMA to others. Discussion/conclusion The pilot was a great success, impacting positively on mentors and mentees. All responding participants would recommend it to others. Mentors and mentees expressed some challenges: finding a mutual time for meetings, and support from employers to use work time for meetings. Questionnaires were not returned by 38% of participants, which is a potential limitation. An identified improvement is to offer mentors an alternative mentee if their original mentee does not make contact. Offer of an annual ENIGMA cohort will continue in Leeds. Additionally, a second pilot is planned in another Integrated Care Board (ICB) to establish how ENIGMA could work in a different area, and if successful, we intend to share this model nationally.

Creating an inclusive workforce in 2024: Are pharmacy teams across England committed to embedding equality, diversity, and inclusion?

Abstract Introduction The Pharmacy Workforce Race Equality Standard (PWRES) published in 2023 provided evidence of the varied experiences that registered pharmacy professionals in NHS trusts face, particularly in relation to gender and ethnicity.1 Following this, the Inclusive Pharmacy Practice delivery group at NHS England set out to raise awareness of the data and to support regions in developing action plans to drive improvements in equality, diversity and inclusion (EDI) within pharmacy teams. Aim The aim of this study was to identify current initiatives within NHS providers that promote EDI within the pharmacy workforce with a view to enabling the sharing of good practice, and identifying implementation barriers. Methods A questionnaire was created by the Chief Pharmaceutical Officer’s Clinical Fellows and distributed by the 6 regional chief pharmacists within NHS England to their networks. The questionnaire was also promoted in regional pharmacy leadership meetings. Responses were collected between 1st February and 31st May 2024. Data was collected on an Excel spreadsheet. London was excluded from data collection as a similar questionnaire was distributed in 2023. No ethical approval was needed for non-sensitive anonymised data. Results There were 77 responses: 75% (n = 58) from hospital trusts, 13% (n = 10) from integrated care boards and the remaining 9 responses included the Local Pharmaceutical Committee, Hospice and Mental Health Trust. 86% of respondents (n = 66) indicated that their organisation has EDI initiatives in place. These have been summarised into six key themes: 1) EDI network/steering group (n = 44), 2) action plan (n = 14), 3) EDI training/accreditation (n =14), 4) reverse/reciprocal mentoring (n = 11), 5) awareness days (n = 10) and 6) inclusive recruitment practices (n = 10). In contrast, only half of respondents indicated that their team had EDI initiatives. The impact of any initiatives was measured by feedback from staff (e.g. Internal staff survey, NHS staff survey, focus groups, open staff forums) and regular staff demographic data collection. 55% of respondents (n = 36) indicated that recruitment panel members received compulsory EDI training for interviews and 54% of respondents (n = 35) received mandatory recruitment training. Barriers and challenges identified with implementing EDI initiatives included organisational change, workforce capacity, competing priorities and staff apathy. Discussion The survey results highlight a strong commitment to EDI initiatives at an organisational level, with most organisations having established EDI frameworks. However, the lower prevalence of EDI initiatives within individual pharmacy teams suggests a gap in implementation. This discrepancy indicates a need for better dissemination and integration of EDI practices within pharmacy team settings. There is evidence of varied practice in terms of EDI training requirements of interview panellists, and these variations are opportunities where improvements can be made in terms of IPP. The survey was only sent to the managed NHS sector and is not reflective of primary care or community pharmacy. One of the next steps is for regions to use the results of the questionnaire in combination with the PWRES data to develop and implement local action plans to address these issues. Reference 1. NHS England. Pharmacy Workforce Race Equality Standard Report 2023. [Accessed 4th June 2024]. Available from https://www.england.nhs.uk/long-read/pharmacy-workforce-race-equality-standard-report/

Development and implementation of autoverification standardization in the adult and pediatric emergency department.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. This project utilized the guidance of the American Society of Health-System Pharmacists (ASHP) autoverification toolkit to refine our health system's approach to autoverification and contribute to the literature regarding appropriate use of autoverification technology in a pediatric and adult emergency department (ED). This single-center quality improvement study was conducted in an academic medical center ED that has 33 pediatric beds and 77 adult beds. A team consisting of clinical pharmacy specialists in emergency medicine, medication safety and informatics personnel, operational managers, and pharmacy leadership was identified to develop and implement autoverification best practices in the ED utilizing practices outlined within the ASHP autoverification toolkit. Before implementation of best practices, defined as the "preoptimization" state, autoverification took place for most medications available in the automated dispensing cabinets (ADCs). By anchoring the autoverification rule on ADC inventory, it was challenging to optimize both inventory practices and autoverification best practices. This project focused on redesigning the autoverification rules in the electronic health record, defined as the "postoptimization" state. In the postoptimization state, autoverification in the ED was updated to better align with regulatory standards. Autoverification metrics and the percentage of orders that autoverified vs required pharmacist verification were analyzed in the preoptimization and postoptimization states. This project utilized the guidance from ASHP's autoverification toolkit to refine our health system's approach to autoverification. High-alert medications (eg, insulin, extended-release opioids, digoxin) were taken off autoverification following implementation. Optimization of autoverification rules allows more orders for high-alert medications to be reviewed by a pharmacist.

Leading Across Health Professions: Reflections on Opportunities and Challenges

Pharmacy leaders are well equipped to serve as academic leaders overseeing additional health profession programs and/or faculty. Organizing multiple health professions programs under one umbrella offers a number of opportunities, such as efficiencies in financial and human resources, expanded and more diverse leadership talent which offers advantages in succession planning, organizational effectiveness in its operations, expanded opportunities for interprofessional education and collaborations in research and scholarship, greater visibility as a partner for establishing pipeline agreements and clinical partners affiliations, and personal professional development and growth for those in senior leadership positions. However, pharmacy academic leaders with oversight over multiple health professions programs and faculty also face challenges in understanding the professional identities and culture of their faculty, complexities of equity of workload across numerous departments, mistrust from departments other than pharmacy, and their own increased workload and possible burnout. The American Association of Colleges of Pharmacy has recently established a new Multi-Professional Health Care Administrative Leaders Connect Community, which should be further promoted to increase membership. Programming to allow additional networking, sharing of best practices, mentorship and professional development of leaders who oversee, or aspire to oversee, multiple health professions programs can be beneficial. Further research can describe different models of organizing multiple health professions programs and identify best practices for successful organizational and operational structures.

Insights into Pharmacists' Participation in Professional Certification Programs in Saudi Arabia.

Professional certification programs play a crucial role in helping pharmacists develop specialized skills and establish their expertise in the field. This study explores how pharmacists in Saudi Arabia engage with these programs by examining their levels of awareness, attitudes, and participation. It also identifies the key barriers and motivators that influence their decision to pursue certification. An online survey was conducted among pharmacists in Saudi Arabia to assess participants' knowledge of certification programs, their perceived benefits, the actual participation rates, and their preferences regarding certification areas and assessment methods. Out of 394 participating pharmacists, around 47% had never participated in a professional certification program, and about 27% of our sample were unaware of such programs in Saudi Arabia. Financial constraints and a lack of awareness were noted as the primary barriers to participation. Almost 55% showed an interest in Clinical Pharmacy Specialties certification, while 54% were inclined toward Pharmacy Management and Leadership certifications. A preference for practical assessments in certification programs was suggested by 55% of participants. This study highlights a significant need for increased awareness and accessibility to professional certification programs among pharmacists in Saudi Arabia. Addressing participation barriers is vital to foster professional development and meet the healthcare sector's evolving demands in Saudi Arabia.

Considerations for developing a health-system 503B outsourcing strategy.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. To provide guidance for health systems on how to develop a strategy for utilizing 503B outsourcing facilities for sterile product preparation. Health-system pharmacies face an increasingly complex set of challenges related to providing sterile products to patients. New United States Pharmacopeia <797> regulations, increasing drug shortages, and an ongoing pharmacy technician workforce shortage have made sterile compounding more difficult than ever for health-system pharmacies. Outsourcing of production to 503B outsourcing facilities is one strategy pharmacy leaders can use to help navigate these challenges. However, there are many factors to consider when deciding whether to outsource a product and which 503B vendors are safe and reliable. The Cleveland Clinic Health System (CCHS) has developed a robust internal structure to appropriately vet 503B outsourcing facilities for safety and reliability, as well as standardized criteria used to determine which products will be outsourced. This article describes the tools CCHS has used to evaluate 503B outsourcing vendors and to evaluate individual products to determine the pros and cons of outsourcing vs insourcing. Additionally, general considerations regarding outsourcing are described. Outsourcing to 503B facilities can be an effective strategy for navigating sterile compounding challenges but is not without some risk. Pharmacy leaders must develop a standardized approach to thoroughly evaluate 503B vendors and products to ensure their outsourcing strategy is both safe and cost-effective.

Competencies, skills, and personal characteristics needed for pharmacy leaders: An in-depth interview

ObjectivesThis study aims to explore the essential competencies, leadership development strategies, skills, values, and personal characteristics required for pharmacists aspiring to leadership positions in Saudi Arabia. MethodsSemi-structured, in-depth interviews, conducted either in person or via video, were selected to confidentially explore the leadership traits and strategies of pharmacists. The study included twelve pharmacists, consisting of 7 males and 5 females, with varying levels of experience: 3 aspiring leaders, 5 current leaders, and 4 retired leaders. A fourteen-question interview guide was developed to investigate the key elements necessary for effective pharmacy leadership development. The guide was pilot tested with two pharmacists, whose responses were excluded from the final sample and subsequent analysis. ResultsThe study revealed significant disparities in the perceptions of leadership skills and personal characteristics among the different groups. The junior cohort, consisting of aspiring pharmacists, emphasized idealistic personal characteristics over practical skills. In contrast, current and retired leaders demonstrated a clear ability to differentiate between personal characteristics and essential skills. Furthermore, the study identified leadership development strategies grounded in the Saudi context, which were particularly resonant with both current and former leaders. ConclusionsThe study examined the essential competencies and leadership development strategies for pharmacists aspiring to leadership roles, revealing notable disparities between early-career individuals and current or former leaders. Future research should focus on bridging these differences in perception and skills through targeted knowledge interventions.

Characterizing the Perceived Need for Advanced Clinical Pharmacy Training in British Columbia.

Currently in Canada there are limited opportunities for advanced clinical pharmacy training after a year 1 residency. Advanced training programs currently in existence are year 2 residencies, clinical Master's degrees, and Fellowships. To characterize the perceived need for advanced clinical pharmacy training in British Columbia and to determine the desired educational competencies to be gained through advanced training. Current pharmacy residents (academic year 2021/22) and residency graduates of the past 5 years (2017-2021), together referred to as early career pharmacists or ECPs, were surveyed. Provincial health authority pharmacy leaders who hire clinical pharmacists were also surveyed and invited to participate in key informant interviews. Eighty-four ECPs and 22 pharmacy leaders participated in the surveys (estimated response rates 26% and 35%, respectively). Eleven (13%) of the ECPs had already completed advanced clinical training, and an additional 24 (29%) planned to pursue such training within 5 years. Sixteen (73%) of the pharmacy leaders had experienced difficulties in filling advanced practice positions over the previous 3 years due to a lack of qualified applicants, and 21 (95%) believed that more advanced training positions should be offered. The majority of ECPs interested in advanced training (39/60, 65%) chose year 2 residency as their preferred program, and 20 (91%) of the pharmacy leaders agreed that British Columbia should offer year 2 residencies. Both ECPs and leaders rated clinical skills and knowledge as the most important educational competencies. Pharmacy leaders expressed a need for more pharmacists with advanced clinical pharmacy training, and many ECPs were interested in pursuing such advanced training. Most respondents preferred the year 2 residency, with the most common goal being to improve clinical competencies.

A call to action: How pharmacy leadership can manage burnout and resilience.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Leadership Development in Pharmacy Students: A Literature Review.

A deeper understanding of leadership competencies and development of these competencies in pharmacy students are essential to enable future pharmacists to take a more advanced role in patient care and serve as interdisciplinary team members and leaders. Such efforts are also needed to help guide succession planning. To identify and describe the competencies and experiences involved in leadership development for pharmacy students. A literature review was conducted using the MEDLINE, PubMed, and Google Scholar databases (from inception to November 2023), as well as syllabi from pharmacy leadership courses. Articles discussing leadership competencies in a health care setting and during pharmacy education and training were included. Competencies and experiences related to leadership development were extracted and organized into categories, with each category given a single descriptor. A total of 34 resources were included in the analysis, which revealed the following 7 leadership competencies: leadership knowledge, self-awareness, collaboration, leading change, business skills, systems thinking, and lifelong learning. Pharmacy students can develop their leadership abilities through a variety of experiences and activities aligned with the core leadership competencies identified here. Pharmacy schools in Canada can design and offer leadership placements to help enhance students' leadership skills. This study has highlighted activities that may help prepare pharmacy students for leadership roles in the changing landscape of pharmacy practice.

Gender balance in Australian pharmacy organisations: Are we there yet?

IntroductionIn the dynamic landscape of healthcare, pharmacists play a critical role in ensuring the well-being of communities, and having solid professional organisations to support pharmacists is essential in crucial activities, including continuing education, advocacy and establishing service standards. Eight pharmacy organisations play vital roles in representing pharmacists in various sectors and collectively contribute to developing, regulating, and promoting the pharmacy profession in Australia. However, a notable lack of female representation in these organisations' leadership roles has led to an increased focus on gender balance and equity. ObjectiveTo determine if the gender distribution in pharmacy leadership aligns with the pharmacy workforce in Australia (64% women) and how it has changed in the five years since our last study on the issue. SettingAustralia. MethodEight key Australian pharmacy organisations were identified. The website for each organisation was accessed, and data were recorded for their 2023 boards/committees/councils based on annual reports. Data recorded include name, number of males, number of females, and the gender of the president/chair of each board/committee/council. ResultsData were obtained for 340 separate professional committee members from the eight organisations (including state/territory branches) in 2023. Gender balance in pharmacy organisations has increased significantly since 2018, with women's representation in leadership positions now at 58% (47% 2018). ConclusionGender equity within Australian pharmacy professional organisations has significantly progressed.

Assessing Hospital Pharmacists' Scope of Clinical Practice in Ontario.

Expansion of the scope of pharmacists' activities in hospital is associated with reductions in adverse events and drug-related readmissions. However, the breadth of hospital pharmacists' clinical activities varies widely across Ontario due to provisions in the provincial Public Hospitals Act. Few data exist defining expanded scope in institutions across Ontario. The primary objective was to describe the scope of practice of hospital pharmacists in Ontario who were undertaking expanded clinical activities based on policies or medical directives. The secondary objectives included determining benefits, limitations, facilitators, and barriers associated with implementing these activities. A survey was sent to the pharmacy leadership of Groups A and B public hospitals across Ontario. The survey contained quantitative and qualitative questions focused on 3 domains of expanded-scope activities: adaptation, discontinuation, and renewal of medication orders; prescriptive authority; and drug monitoring. Of 56 hospitals invited, 46 (82%) submitted a survey response, with 1 exclusion (due to no response on some mandatory questions). The most common expanded-scope activity was independent performance of therapeutic drug monitoring (71%, 32/45). Pharmacists had the authority to independently adapt, discontinue, or renew inpatient medication orders in 60% (27/45) of hospitals, and could independently initiate medication orders in 20% (9/45). Barriers to implementing expanded-scope activities included limited time and staffing. Facilitators included proactive leadership, demonstrated clinical value, and strong rapport with other health care providers. Many institutions in Ontario have established polices to expand pharmacists' clinical activities, but there is a great deal of variability in scope of practice. Advocacy at the provincial level to unify scope of practice will help to optimize patient outcomes.

Developing pharmacy leaders: A design thinking approach to navigate the leadership crisis in pharmacy.

Developing pharmacy leaders: A design thinking approach to navigate the leadership crisis in pharmacy.

Managing the unexpected: considerations for new pharmacy leaders.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Results from a global pharmacy leadership needs assessment: Opportunities to advance pharmacy leadership

Background: Leadership skills in the pharmacy profession are essential for career development and advancement. Pharmacy education is often not focused on developing these leadership skills. This study determines the exact pharmacist leadership traits needed across the globe. Methods: A three-part leadership needs assessment was developed by three International Pharmaceutical Federation (FIP) global leads for leadership development. Pharmacy management leaders within FIP headquarters vetted the survey for external validity, and their feedback was incorporated. In January 2021, the survey was disseminated to around 3000 FIP members using Qualtrics. The survey took approximately 15 minutes to complete 28 questions. Qualitative and quantitative analyses were used for the data. Results: A total of 239 participants (~8%) completed the survey. On average, participants felt that innovation/entrepreneurship, negotiating, strategic context, conflict management, and vision were among the top five leadership competencies that they would like more training in. When stratified by work setting, pharmacists in academia ranked conflict management, in inpatient hospitals ranked change management, and in community/retail settings ranked prioritisation as the top leadership competency need. Conclusion: Pharmacists in different work settings and different parts of the world have a need for different leadership skills which should be carefully considered when providing leadership training.

The need for an emergency planning and preparedness strategic plan for pharmacy leadership.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.

Abstract TP47: When Folks Stroke at a Freestand: Building Successful Stroke Workflows for Freestanding Emergency Departments

Background: Services offered at freestanding emergency departments (FSED) vary and often have inconsistent clinical education and workflow standardization. Delivery of clinical education and implementation of hospital-based emergency department (ED) workflows to FSEDs contributes to a successful system of care. All sites in a mostly rural region are held to PSC standards with 24/7 ED physician coverage from a local, contracted group. All sites have 24/7 neurology provider coverage from an internal Neurohospitalist group that responds to stroke alerts in person or via telestroke. Nursing, radiology, and pharmacy leadership across the region participate in regional stroke and quality committees. Methods: Clinical education for FSED staff aligns with hospital-based EDs but includes competencies related to lack of ancillary services at the FSEDs. NIHSS certification is required and renewed every two years. Quarterly stroke education posters team are at all sites and new hire training is standardized. Availability of thrombolytics is maintained by pharmacy even though they are not on site at FSEDs. Volume and accuracy of 2022 stroke alert activations were reviewed as were door to CT first slice times, total thrombolytic cases, and median D2N times. FSED data was compared to local hospital-based ED outcomes and national stroke standards. Results: There were 27 total FSED stroke alert activations in 2022; 13 had a final coded stroke diagnosis. This 48% accuracy rate is above the range of 35-40% across the region’s hospital-based EDs and meets national standards for alert accuracy. Median door to CT time was 20 minutes and is among the best for the region though slightly longer than national standards. There were 5 FSED thrombolytic cases with a median D2N time of 55 minutes—below the 60-minute national recommendation for treatment time. Conclusion: Providing clinical education and standardizing workflows in the FSEDs resulted in stroke metrics aligning with (or exceeding) regional and national standards. leading to a positive impact patient care when stroke patients present for emergent evaluation and treatment at a FSED.